Related Experiment Video
Updated: Jan 30, 2026
A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Vaginal birth after cesarean: maternal and fetal outcomes in a multicenter study
Mehmet Nuri Duran1, Serem Kel Ilgin2, Süreyya Saridas Demir3
1Department of Obstetrics and Gynecology, Medical Faculty of Canakkale, Onsekiz Mart University, Canakkale, Türkiye.
Objective:
Trial of labor after cesarean (TOLAC) has reemerged as an important strategy to lower rising cesarean rates and provide women with a safe alternative to repeat surgery. Successful vaginal birth after cesarean (VBAC) may also reduce long-term complications associated with multiple cesarean deliveries. Despite this growing interest, data from high-fertility regions remain limited. This study evaluated outcomes of TOLAC in secondary-level hospitals in Türkiye and compared them with elective repeat cesarean section (ERCS).
Methods:
This retrospective multicenter cohort included women with ≥1 prior low-transverse cesarean delivery between January 2020 and January 2026. Eligible patients underwent either ERCS or attempted TOLAC, which resulted in VBAC or emergency cesarean. Maternal characteristics, peripartum variables, and neonatal outcomes were assessed. Crude risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.
Results:
Of 19,768 women with a previous cesarean, 2,185 (11.1%) attempted TOLAC and 17,583 (89.0%) selected ERCS. VBAC was achieved in 1,464 women (67.0%), while 721 (33.0%) required emergency cesarean. Compared with ERCS, VBAC was associated with lower risks of gestational diabetes (RR 0.68; 95% CI 0.52-0.89) and pregnancy-related hypertension (RR 0.62; 95% CI 0.44-0.89). Emergency cesarean was linked to higher transfusion requirements (RR 1.36; 95% CI 1.02-1.82). Uterine rupture was rare across groups. Neonatal outcomes were broadly similar, although fetal acidosis appeared more frequent after failed TOLAC.
Conclusions:
VBAC success rates in this cohort aligned with contemporary international benchmarks and demonstrated favorable maternal outcomes in appropriately selected patients. Emergency cesarean following failed TOLAC represented the highest-risk pathway, emphasizing the need for meticulous intrapartum monitoring and timely surgical readiness. Expanding safe TOLAC programs may reduce unnecessary repeat cesarean deliveries in high-fertility settings.
Related Concept Videos
01:22Birth Control Methods
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:22Case Studies